The Head of Claims (Regulated Individual) will oversee the company’s relationship with outsourced claims handlers across all product lines, ensuring their activities are conducted with due care and in compliance with all relevant legislation, including Consumer Duty.
The role provides assurance to the Board on claims governance and performance, offering functional oversight of claims operations and acting as the main contact for regulatory queries and thematic reviews.
Key Responsibilities:
- Oversee outsourced claims handlers (e.g. EUI Limited, Able Limited), ensuring alignment with company standards.
- Monitor performance data, including KPIs and bordereaux, identifying risks, trends, and areas for improvement.
- Provide guidance on complex or high-value claims, including approval of UK motor ex gratia settlements above £10,000.
- Maintain oversight of long-tail (non-Bodily Injury) claims and act as escalation point for significant or high-value cases.
- Prepare quarterly reports for the Board on claims performance, regulatory developments, and key operational issues.
- Serve as the primary contact for regulatory queries and reviews, ensuring compliance with GFSC requirements and best practice standards.
- Promote fairness, accountability, and a customer-centric approach throughout the claims process.
- Strengthen systems and controls to maintain accuracy, efficiency, and resilience.
- Review and challenge reporting from outsourced partners to ensure accuracy and relevance.
Requirements:
- Extensive experience in insurance claims management, including complex and high-value cases.
- Strong understanding of claims processes, risk management, and performance monitoring.
- Knowledge of regulatory frameworks in Gibraltar and/or the UK and experience managing regulator relationships.
- Technical expertise across claims operations and outsourced arrangements.
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